April is Autism Awareness Month, so I write this article in honour of all the people, parents and loved ones whose lives have been touched by this condition. Doctors, educators, caregivers and the community at large need to celebrate the advances science has made in understanding these individuals. Regrettably to date, we are nowhere near having all the answers. In fact, as new research sheds light in one area, it leads down another path where there are just as many questions. That is not to say that our knowledge base about autism is not growing. We now understand more about how the environment has an impact on the genes of predisposed individuals.

The actual statistics are alarming to say the least. When I first began my practice 40years ago, it was rare to see or even hear of a case of autism. Now, it is all too common. Some 20 years ago, one child in 20,000 was affected. Today, a staggering one in 88 children in total and one in 54 boys are touched by this condition and it’s getting worse. While it is true that better recognition, diagnosis and awareness have led to an increase in Autism diagnoses, none of the “experts” believe these factors are the sole explanation for such a dramatic rise in incidence. At the very best, better diagnostic criteria could only account for a 50% increase in prevalence of the disorder. Clearly, there must be other issues at work.

There are certain criteria for the diagnosis of autism contained in the DSM IV (Diagnostic and Statistical Manual of Mental disorders). These criteria are based on social interaction, verbal and non-verbal communication, and repetitive or stereotypical behaviours. We use the term Asperger syndrome when the individual lacks the usual delays in cognitive and language development, and is considered “high functioning.” The term Pervasive Development Disorder is used when the individual does not fit clearly into the criteria of either autism or Asperger syndrome; essentially, a “catch all” term.

All areas of the brain – all the little sulci and gyri or, to say it another way, all the little nooks and crannies – have a very specific function that they are responsible for. For example, your speech, your math skills, your executive function and even your ability to predict the consequences of your actions have a specific location that they “live” in. In autism, recent research in brain mapping has shown that many of these areas do not talk to one another as in a normal brain, referred to as reduced connectivity. This lack of connectivity literally means that there are disconnected parts of the brain.

Research has also clearly shown a correlation between autism and environmental neurotoxins including pesticides and over 100 chemicals routinely used in everyday living. Certain other risk factors have been found both in Eindhoven (Holland) and Silicon Valley (California) where the rate of autism is one in 15. The high prevalence of autism in these geographic locations is thought to be associated with being the off-spring of highly intelligent parents in the fields of engineering technology or science.

Exposure to stress chemicals and other hormone imbalances in the womb are also a known contributor. Exciting emerging research has linked inflammation to both the mother and her foetus. In other words, when the mom has high levels of inflammation, due to high levels of antibodies, the developing foetal brain will suffer the consequences of this imbalance. The high levels of antibodies coursing through the system can be linked to the “second brain,” the enteric nervous system or, simply, the gut. Foods are incompletely broken down in the gut and thus allowed to enter the bloodstream.

These foods in the bloodstream trigger an immune response, which produce inflammatory chemicals, including the aforementioned antibodies. These inflammatory chemicals readily cross the blood-brain barrier triggering an immune response throughout the brain. This neuro-inflammation phenomenon is sometimes colloquially referred to as a “brain on fire.” Caseomorphins and gluteomorphins are opiate-like substances found at high levels in autistic children. These caseomorphins and gluteomorphins are partly digested proteins found in dairy and grains, especially wheat. They are additives and highly toxic to the brain. They are also found in the urine of patients with other neurological disorders including schizophrenia.

There are rare and purely genetic forms of autism which are usually the most severe and troubling cases. However, it appears that there is a “soup” of other environmental factors which “trigger” the developing brain to run amuck. I speak and teach to the lay public and doctors about the neurology and biochemistry of developing brains and would like to share with you one question I received from a concerned member of an audience, who asked me if I thought that individuals with autism were here to teach us, because in many cases, they have exceptional skills and intellect. I couldn’t agree more. As the research progresses, it clearly points to the fact that what we put into our bodies and the environment has a large impact on the developing brain. These environmental influences trigger a genetic response that leads to the suffering of these individuals and their loved ones.